Michael Devlin: Help when the applause fades  

Michael Devlin calls for an appreciation of the health and wellbeing impact of the pandemic on frontline staff

Public appreciation for the work of clinicians and other carers has grown during the pandemic. Yet while it is good to know that your work is valued, the unrelenting strain of being on the frontline during a prolonged health crisis is bound to exact a heavy emotional toll. 

Doctors are used to dealing with high pressure situations, seriously ill patients, and heavy workloads, but the covid-19 pandemic has magnified these challenges. It has also added new burdens, such as the trauma of seeing patients die alone and the need to break bad news to distressed families while socially distancing. Along with taking responsibility for many life or death clinical decisions, doctors also face the constant worry of contracting coronavirus and passing it to loved ones. 

The mental health impact for clinicians is only just becoming clear. In a survey of 250 Medical Defence Union (MDU) members, including consultants, GPs, trainees, and staff grade doctors, 70% of respondents said their stress and anxiety levels had deteriorated since the beginning of the pandemic, with 22% reporting they were significantly worse. 

The survey revealed the various ways that work affects respondents’ wellbeing, with 55% stating that they felt anxious and/or stressed on a weekly basis, and 40% reporting that they often went to work when they didn’t feel fit or well. Thirty two per cent agreed that their relationships at work were strained and the same proportion felt unable to do their job effectively. 

It’s worrying that the pandemic may act as a catalyst, exposing vulnerable healthcare professionals to greater adversity and pushing many to breaking point. Others may find the effects catch up with them in the months and years ahead, although it is too early to tell what the price on doctors’ mental health will be. A recent report Care Fit for Carers by the thinktank IPPR identified significant mental and emotional health concerns among healthcare workers. 

The IPPR report called for a set of guarantees for healthcare workers’ personal safety and mental health. One area not addressed in the report is the potential for clinicians to face the stress and anxiety of facing a claim for compensation related to the pandemic. The distress and worry felt by doctors responding to a claim should not be underestimated, especially in the context of the potential for deteriorating mental health during and following the pandemic.

While healthcare professionals must be accountable for their actions, the unprecedented circumstances in which care was provided during the pandemic means it would be unjust to judge them against the traditional benchmark of a non-crisis standard of care, which preceded the NHS’s response to covid-19. For this reason we are calling for the government to recognise the exceptional circumstances of the current emergency and to protect NHS healthcare staff and institutions by introducing legislation to exempt the NHS from covid-19 related clinical negligence claims.

Mental wellbeing is a complex issue and there is no quick fix or single solution. It is important for healthcare professionals to have strategies in place for coping with adversity, recognising warning signs in themselves and others, as well as being aware of barriers to seeking help. 

Thankfully, there has been a focus on this area during the pandemic and the government has introduced a number of initiatives, including an NHS wellbeing support helpline, to encourage healthcare workers to seek help if they are struggling. The MDU also has a free health and wellbeing e-learning course for foundation doctors, which includes advice on how to identify the warning signs of burnout in yourself and others and strategies to help to avoid reaching this stage.

The pandemic is a tragedy but it is also a reminder that we depend on the resilience and commitment of our fellow healthcare professionals. We need to show them that they can depend on us too.  

Michael Devlin is the MDU’s head of professional standards and liaison.

Competing interests: None declared.